Does breastfed baby need iron supplements?

I'm breastfeeding my five month old son. The pediatrician recently recommended that I begin iron-fortified rice cereal. I have no problem starting solids, however, my La Leche League breastfeeding companion book states that my breastmilk provides enough iron for the baby, and in fact, supplementation would be harmful. My doctor thinks the baby needs iron supplementation what should I do???


Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Lee Ann,

Breast milk contains a small but significant amount of iron which is well utilized, but its effectiveness in preventing iron deficiency merits further study. The American Academy of Pediatrics Committee on Nutrition has noted that only rarely has breastfeeding been associated with iron deficiency. This may be based in part on the good absorption of the small amount of iron present and that intestinal blood loss is rare in breast fed infants in comparison with infants fed fresh cow's milk. However, because animal studies indicate that iron deficiency anemia early in postnatal life results in abnormalities of some organs, most importantly the brain, they recommend iron supplementation.

It is suggested that for infants who were full term and are breast fed the best source of iron is iron- fortified cereal, two portions a day. These two portions will provide the recommended daily intake of 15 mg. of iron.

I have not read any research or infant nutrition books that suggest iron fortified infant cereal can be harmful. Too much iron can be harmful, and this is why you should not keep iron drops in the house that provides more than a month's supply, nor should they be in reach of the children. However, there is no harm in your baby overdosing on iron-fortified cereal. Because the potential benefits outweigh the unknown harm of iron-fortified infant cereal, I suggest you begin the iron fortified cereal as your doctor has recommended.

Thank you for writing.

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